Clinical Value of Washed‐Platelet Concentrates in Patients with Non‐Hemolytic Transfusion Reactions

We closely observed 86 transfusions to multitransfused hematologic patients with leukocyte-depleted platelet concentrates (PCs) prepared from buffy coats (BC PCs), filtered either prior to storage (BC1) or after 3-4 days’ storage (BC3). The patients were first given, randomly, either BC1 or BC3, and were thereafter used as their own controls by giving them the two BC types alternately. The results were compared with an earlier study on standard platelet-rich plasma (PRP) PCs (46 transfusions to 23 patients) and leukocyte-depleted PRP PCs (23 transfusions to 12 patients). There was no difference in adverse reactions between BC1 and BC3 PCs, but BC PCs caused significantly fewer and milder adverse reactions than PRP PCs. Febrile reactions (FTR) occurred in 4.6%, urticarial skin reactions in 21%, and pulmonary reactions in 0% of BC PC transfusions (17, 29 and 0% of patients). The mean corrected increments (Cl) at 16-18 h were higher after BC1 PCs than BC3 PCs (10.3 vs. 8.0, p = 0.046). We conclude that adverse reactions are reduced by use of BC PCs. Prestorage leukocyte depletion may improve platelet increments.

Section: Platelet Incrementsmentioning

confidence: 99%

Adverse Reactions to Platelet Transfusions Are Reduced by Use of Platelet Concentrates Derived from Buffy Coat

Oksanen¹,

Ebeling²,

Kekomäki³

et al. 1994

“…To date, platelets have been washed with saline or sa line plus acid-citrate-dextrose (ACD) solution [8][9][10][11], However, ACD saline-washed platelets had a low in vivo platelet recovery compared to nonwashed platelets and did not effectively shorten the bleeding time in one study [11], It is probable that a rapid deterioration of platelets took place when suspended in ACD saline solution since the solution had neither the proper ionic composition nor the proper pH level. A potential fall in pH in washed PCs may be the main reason for the loss of in vivo platelet recovery.…”

Section: Introductionmentioning

confidence: 99%

Plasma-Depleted Platelet Concentrates Prepared with a New Washing Solution

Shimizu¹,

Shibata²,

Kora³

1993

In certain clinical situations, complete removal of the plasma proteins from the platelet concentrates (PCs) is necessary by washing prior to transfusion. A simple electrolyte solution with a pH of 6.5 was developed for washing PCs. The platelet-rich plasma collected with acid-citrate-dextrose solution by apheresis in a 0.6-liter polyolefin bag was centrifuged. After removal of the supernatant plasma from pelleted platelet buttons, 200 ml of a washing solution consisting of 90 mM NaCl, 5 mM KCl, 3 mM MgCl(2), 17 mM NaH(2)PO(4), 8 mM Na(2)HPO(4), 23 mM Na acetate, 17 mM Na(3) citrate, 23.5 mM glucose, 2 mM adenine, 0.1% dextran, and 28.8 mM maltose (pH 6.5) was added to the pelleted platelet button. Steam sterilization of the solution was carried out under nitrogen to avoid caramelization of glucose. After resuspension of the pelleted platelet button with a washing solution and a second centrifugation. Seto additive solution (Seto sol, pH 7.4) was introduced into the bag to resuspend the platelet buttons for storage for 3 days at 22°C. All of these procedures were completed within 3 h using a sterile docking device. In washed PCs, 99.1% of the plasma was removed and platelet recovery was 96%. The washed PCs were compared for 3 days with plasma-poor PCs consisting of 11% plasma and 89% Seto solution. There were no significant differences in percent hypotonic shock response, aggregation, energy metabolism, and morphology of platelets between the two groups during 3 days, except for significant swelling of 3-day- old platelets in washed PCs. We conclude that washing PCs with a newly developed medium and resuspension by Seto sol (pH 7.4) had minimum detri- menal effects on further storage for 3 days. It is indicated that the procedure described here is relatively simple and can be finished within 3 h after the collection of platelets, and since plasma removal was sufficiently high, a new plasma-depleted PC product may be a valuable therapeutic tool for hemostasis therapy with reduced side effects from plasma proteins.

“…Foremost has been the use of a pH 6.5 citrate-buffered reconstitution medium. The use of simi lar nonplasma solutions had been found suitable for washing fresh platelets for transfusion, and more recently also for washing DMSO-frozen platelets [19,20]. The composition of the nonplasma diluent was kept simple to allow for additions later (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Addition of 2.5 mMCaC^ (0.01 ml) preceeded challenge with 20 \xM epinephrine (0.025 ml), 1.9 U/ml bovine thrombin (0.01 ml), 19 \lM ADP (0.01 ml), and 0.7 mg/ml collagen (0.01 ml). The epinephrine and thrombin were purchased from Parke-Davis, Detroit, Mich., USA, and the ADP and collagen from Sigma Chemical, St. Louis, Mo., USA.…”

Section: Treatment Of Frozen Pc For Aggregation Studiesmentioning

confidence: 99%

Improved Procedure for Platelet Freezing

Dayian¹,

Harris²,

Vlahides³

et al. 1986

Platelets frozen in glycerol-glucose frequently aggregated on thawing or reconstitution. This has been eliminated by using a nonplasma diluent (pH 6.5) and a new freezing bag. The results were improved platelet 14C-serotonin uptake and readily demonstrable aggregation to ADP, epinephrine, collagen and thrombin. 14C-serotonin uptake was at maximum when platelets were frozen at thrombocrits of up to 15%. Hemostatic effectiveness was demonstrated in a severely thrombocytopenic patient with acute myelogenous leukemia in relapse, who was supported entirely with two autologous frozen platelet transfusions for the 13 days before bone marrow activity resumed.